Rotator Cuff Tear Overview
The rotator cuff is the name for the four muscle-tendon units that surround and help control the shoulder joint throughout its range of motion. A rotator cuff injury is the most common shoulder affliction found in patients living in the Dallas, Frisco and Fort Worth, Texas communities. People with rotator cuff conditions often have pain with many common activities such as reaching and lifting. Two common injuries to this structure, rotator cuff tears and tendinitis can interfere with sleep and become very frustrating. The shoulder specialists at Texas Sports Medicine specialize in rotator cuff injuries and are available to help return patients to the sporting activities they love following an injury.
What is a Rotator Cuff Tear?
The rotator cuff surrounds the shoulder joint, much like a cuff on a shirt sleeve, and allows the joint to rotate outward, upward and inward. One or more of the muscle-tendon units that compose the structure can become injured from a fall, sports injury or degeneration from the body aging. In the majority of cases, a rotator cuff tear involves the supraspinatus tendon and muscle, but any muscle-tendon unit can experience damage.
When a tendon becomes torn, there is a separation or “tearing” of the tendon from the humerus head. A rotator cuff tear is classified by shoulder specialists as either a partial or a full-thickness (complete) tear.
- Partial tear- The tendon experiences damage but does not completely sever
- Full-thickness tear- The tendon is torn completely off the attachment site at the bone
Rotator cuff injuries, both a tear and tendonitis, are caused by an acute traumatic injury or degeneration from the natural aging process or continued overuse of the shoulder joint. Two common acute injuries include falling on the shoulder joint or lifting an object too heavy.
Rotator Cuff Tear Symptoms
- Shoulder pain and weakness
- Pain that is present at night when lying on the affected joint
- Pain when lowering and raising the arm, as well as rotating the arm
- A popping or cracking sensation when the arm is moved in certain positions
Rotator Cuff Tear Treatment
Treatment of a rotator cuff injury depends upon the degree of damage to the tendons. Most conditions involving the rotator cuff respond readily to conservative measures.
Nonoperative
- Rest
- Stop all activities that worsen symptoms
- Modify activities
- Change daily and work activities to decrease joint inflammation
- Medications
- NSAIDs to reduce pain and swelling
- Ice
- Use ice and cold compresses to decrease joint inflammation
- Physical therapy
- Designed to restore blood flow, increase joint range of motion and continue the healing process
- Injections
- Platelet rich plasma (PRP) may augment the healing potential for partial tears
Operative
- Rotator cuff repair
- Surgical technique: Instead of making a large incision, a surgeon uses three small incisions during an arthroscopic approach. Through one incision, an arthroscope (small camera) is inserted to look inside the shoulder. Special instruments are then inserted through the other two incisions that allow the removal of scar tissue and bone. A surgeon will then insert sutures and/or anchors with sutures into the shoulder. We use special instruments to weave the sutures through the torn tendon.
After Surgery
- Sling use until advised
- Use a machine called a Continuous Passive Motion (CPM) chair to move the affected arm in the correct planes at home for 4 weeks after the operation
- Use ice packs for one hour after each chair session
- Examination 4-6 weeks after surgery to determine when formal rehabilitation will start
- Begin strengthening exercises around 3 months
- Return to play varies from patient to patient
To learn more about a rotator cuff tear, please contact the Dallas, Frisco and Fort Worth, Texas area shoulder specialists at Texas Sports Medicine today.